DCIS did not clear margins in mastectomy

[weety911]

I know that having clear margins in an invasive tumor are most important (these fortunately were cleared by mastectomy) but am unsure of how important it is to have clear margins of DCIS.  I had a mastectomy, but because of my small breast size and lack of added fat layers ( I am only 98 lbs), the DCIS did NOT clear the margins.   The surgeon said he took all the tissue he could possibly take--there was no more to take. DCIS is supposedly contained within the milk ducts, so what does this "not clear" margin mean for me?
Thanks

[bluebutterfly2222]

Your question is a little confusing to me.

In the first part you seem to indicate that clear margins were obtained  for an invasive tumor through mastectomy.  Then you go on to suggest that your DCIS did not have clear margins.  (This would be unusual, because if it were truly DCIS, it would be within a duct, as you commented,  which should be able to be removed completely...)

Do you have a copy of your pathology report? If you could share the results verbatim, perhaps someone will be able to clarify the meaning for you.  The best option, however, would be to discuss your  procedure and the path. results with your surgeon, until you are satisfied that you understand your situation completely.

Best wishes...

[weety911]

Yes, I know my question is confusing, that is why I'm asking about it because it really is strange!  Let me try to explain it a bit better.  I had a mastectomy, and the pathology report found 2 different breast cancer concerns.  One was the primary tumor.  This tumor was removed with clear margins.  The pathology report also stated that DCIS was "extensively present" throughout the breast.  It states, "DCIS is present at deep resection margin and only 1mm from anterior/superficial margin."  This is why I am wondering how in the world it could be present at the margins when DCIS is contained within the milk ducts.  I asked my surgeon about it and he just said that because of my tiny stature (I am only 98 lbs and barely an "A cup") that there was no extra fatty tissue in the breast between the ducts.  I still don't understand, though.  I was breastfeeding at the time of diagnosis, so the ducts probably were enlarged and full of milk, but I'm still trying to understand how contained cancer cells could be present at the margins.

Does this help any with your understanding?

[bluebutterfly2222]

Thanks for taking the time to clarify your post. I thougnt that that was what you meant, but wanted to be sure there were indeed two different BC concerns.  I can understand your confusion and concern.

I have read in some of the BC Expert Forurm answers that there are cases where the surgeon just can't "get it all" for one reason or another. What the "not clear margin"  may mean is that radiation should be considered. Has that been proposed? If not, you might want to have your operative record and path. report reviewed by a radiation oncologist, to get an expert opinion.

Sorry I haven't been able to offer much help!

Best wishes...

[bluebutterfly2222]

P.S. I noticed that you have posted your question in the BC Expert Forum. That is good!

While you are waiting for an answer from the doctor, you might also want to look at a previuosly answered question, relevant to yours, in the archives of that forum.  It was titled "Margins" and was posted by maggiec on 7/7/04. You could also get to it by clicking on the last post with that name in the list of "Related discussions" just below my reply to you.